The inventions disclosed herein relate generally to improved medical care for intubated patients, and more particularly to a novel multiple access respiratory port, assembly, manifold, fitting, adaptor, connector and/or access control assembly inventions, and related methods, for ventilating, aspirating, monitoring, sampling, and providing therapeutic delivery to the respiratory tracts of intubated patients, including infants, adolescents, and adults.
Respiratory patient care is a dynamically developing field in medicine, ranging in its needs from infants to the aged. The range of respiratory ailments, both temporary and permanent, to which such patients are subjected, are many and varied. For example, the range of procedures for intubated patients may include the following: ventilation, aspiration, oxygenation, sampling, visual inspection, in-line sensing, pressure monitoring, flushing, medicating and/or lavage. Most problems now center or focus on multiple needs of the patient and accommodation of multiple treatments, some to be performed at the same time. The lack of equipment to facilely, efficiently, and safely accomplish the multiple therapies in the best interest of the patient has been and continues to be a concern.
For example, in low lung capacity patients, such as premature babies and adults suffering from emphysema, one problem is the removal of accumulated lung secretions. It is undesirable to starve such patients of oxygen during the secretion removal process. Secretion removal is accomplished via a suction catheter which is temporarily positioned via a respiratory access assembly in an artificial airway, i.e., an endotracheal tube placed in a portion of the patient's respiratory tract to provide air (oxygen and other gases) to the lungs of such patients.
With these and other patients undergoing respiratory care while intubated, problems may occur, including problems with a respiratory access assembly. Unsafe extended use of a respiratory access assembly for ventilating, aspirating, suctioning and other functions may result in hospital acquired infections, such as, for example, ventilator acquired pneumonia. Also of concern is the reliability of such respiratory access assemblies. Further, the need to open the ventilator circuit to exchange devices and perform other therapeutic treatments is also a concern.
A respiratory access assembly needs to be quickly and easily removed and exchanged without compromising the quality of health care to the patient. Also of concern with a respiratory access assembly is inadvertent conversion from a closed respiratory system to an open respiratory system via malfunction of a respiratory access assembly. Further, stress to the patient caused by inadvertent partial obstruction or occlusion of air passageways in the closed respiratory system to and from the patient's lungs due to malfunction of a respiratory access assembly is a problem. Moreover, dealing with a large inventory of a variety of incompatible components manufacturered by different manufacturers which may form the respiratory access assembly is also an issue to the health care provider. Therefore, it would be desirable to have an easy to operate, fail-safe, closed-system respiratory access assembly which provides safe and predictable closed-system access to an intubated patient's respiratory system for multiple purposes, and which has safety features to reduce or eliminate inadvertent damage of the closed respiratory system.
The present invention addresses these needs, providing a respiratory access assembly used in a closed system which includes a safety lock. That is, the present invention substantially alleviates problems which occur with present respiratory access assemblies or devices. The present invention operates in a closed ventilating system and accommodates multiple access to the respiratory system of an intubated patient without compromising the closed circuit character of the system and without interruption of the flow of ventilating gases to the patient. Access to the closed respiratory system through one or more access sites is provided, for example, but not by way of limitation, to ventilate the lungs of the patient with gas or gases, to aspirate secretions from the lungs, to oxygenate the lungs to eliminate or reduce residual carbon dioxide therefrom, to visually inspect selected parts of the patient's respiratory system, to sample sputum and gases, to sense parameters such as flow rates, pressure, and/or temperature, to flush with solution(s), and to administer medication, gases, and/or lavage.